Educational Challenges for Childhood Cancer Survivors

by Alma Morgan, MEd

Today, more than ever before,
childhood cancer survivors are
experiencing academic success.
Many of these survivors are graduating
high school with honors; attending
colleges and universities of their
choice; going to law school, medical
school, receiving postgraduate and doctorate
degrees; and entering the world
of work in their chosen career paths.
How is this possible? First, these
young people are survivors; they are
living. Second, they are not letting
the fact that they had cancer get in the
way of their future goals, dreams, and
aspirations. Third, they are seeking
guidance and support from those who
can aid them in their endeavors.

Of course, these same young people
who are surviving childhood cancer
have also been faced with obstacles
that stand in the way of their academic
success. These young people often experience
late effects of treatment that
leave them with physical and cognitive
challenges. While many of these late
effects do not show up until years
after treatment, they are still challenges
that must be addressed in the educational
setting.

At the same time, many of these
young people had to cope with being
socially isolated from peers, leaving
them with social-emotional challenges
that would need to be dealt with in
later years. Consequently, these physical,
cognitive, and social-emotional
challenges greatly affected the education
of these childhood cancer
survivors, but with strong will and
determination, they have persevered
and been academically successful.

These young people often experience late effects of treatment
that leave them with physical and cognitive challenges.

Alma Morgan

In working with these children and
teens, I have found that these young
people are overachievers. They put
forth the hard work and effort needed
to assure success. The teens and young
adults talk about spending four to six
hours on homework at night when their
peers are only spending two hours to
make the same grade. They learn to
compensate for short-term memory
loss, difficulty with word retrieval, neuropathy
in the hands and feet, slower
processing, fatigue, low stamina, and
many other challenges.

Members of the comprehensive
teams in medical centers are addressing
their limitations and deficits. Hospital
teachers and educational consultants
follow these children and teens
throughout their school careers and
into their adult lives. Neuro-psych
evaluations are administered to determine
their strengths and weaknesses
and to offer strategies for dealing with
the areas of weakness. Schools are being
educated on childhood cancer, with
emphasis being given to diagnosis,
treatment, side effects, and accommodations
needed in the school setting
to address their needs. These accommodations
can be provided through
educational plans such as an Individualized
Education Plan (IEP) or a
504 Plan.

A few of the most frequent accommodations
requested for childhood
cancer survivors are as follows:

Two sets of textbooks, one for home
and one for school. Many backpacks
can weigh 40 lbs. or more, which is
too heavy for a student who is dealing
with fatigue and stamina issues.

Modifications in the physical education
curriculum. Many survivors
are physically unable to participate in
contact sports, strenuous exercises,
and long distance running.

Extra set of notes in lecture classes.
This is particularly helpful for students
who are experiencing neuropathy in
the hands.

Use of word banks or formula banks
to assist with short term memory loss
and word retrieval deficits.

Extended time to complete classwork,
tests, and quizzes. This is
helpful for those who have slower
processing and cannot finish assignments
and tests within the given time.

Calculator and math manipulatives
for math assignments. Visual aids and
manipulatives are often helpful to those
who need a multi-modality approach.

Moderate workload with emphasis
on quality versus quantity. For
example, in mathematics, if a student
can show he can master the concept
by doing 10 homework problems
rather than 20 problems, this would allow
for time to rest or engage in
extracurricular activities that were not
possible during treatment.

In addition to the accommodations,
class in-services using puppets and
other resources are being conducted
for classmates by educational consultants
and other
medical team
members so that
young people can
bring encouragement
and support
to the survivor.
Even at the college
level, staff
may need to be
educated because the cancer survivor
is often entering or returning to school
years after treatment. While the survivor
may look wonderful, physical,
cognitive, and social challenges may
be hidden. Even then, professors,
employers, and staff in the college’s
Office of Students with Disabilities are
usually more than willing to work with
the survivor if needs are expressed.

♦ ♦ ♦ ♦ ♦

Alma Morgan is an educational
consultant for the Hospital Education
Program at Virginia Commonwealth University
Medical Center in Richmond, VA.
She visits more than 90 schools each year,
assisting with writing educational plans
and conducting in-services for students
and staff.

This article was published in Coping® with Cancer magazine,
January/February
2008.